The NORTH (Navigating Ottawa Resources To Improve Health) Clinic, University of Ottawa (Canada)
The NORTH (Navigating Ottawa Resources To Improve Health) Clinic received an honorable mention for the 2022 MacJannet Prize. The Clinic was founded at the University of Ottawa in 2018 as part of a shift towards greater emphasis on social accountability at the Faculty of Medicine. The initiative was jointly established with the University of Ottawa’s Faculty of Law, which lends itself to a unique interdisciplinary collaboration. The model for NORTH was inspired by the Health Leads program in Boston, where interdisciplinary groups of student volunteers served as navigators for patients referred for social needs from healthcare settings. The NORTH Clinic was set out with the goals to improve health equity for marginalized populations, specifically Ottawa’s refugee population, and to enrich the educational experiences of future professionals, specifically medical and law students, through the use of experiential learning.
The NORTH Clinic is a student-run clinic composed of an executive team with representatives from the Faculties of Medicine and Law. There are a number of executive roles and responsibilities, including co-lead, training, scheduling, clinic flow, communications, and research and ethics, that are shared equally between students of the two disciplines. Students are supported by a faculty lead from both disciplines, enabling students to clarify how NORTH fits into their respective program’s curriculum and associated issues like evaluation, recruitment and insurance. The clinic initially ran two clinics per week out of the Somerset West Community Health Centre (SWCHC), with the Ottawa Newcomer Health Centre as its referral base. At each clinic, one medical student and one law student were paired to meet clients, investigate their needs through interviewing, and subsequently research available and eligible community resources.
During each shift, students were supported with the expertise and guidance from experienced community social workers. Since the start of the COVID-19 pandemic, the model of the clinic quickly adapted to provide services virtually through secure communication platforms, while providing teleconference phone services to clients without internet access. Community consultations and needs assessments were conducted to determine a community and organization with a high need for support due to pandemic pressures. With the support from the Faculty and NORTH Clinic executives, a new collaboration was established with the Vanier Social Pediatric Hub (VSPH) in 2021, serving underserved populations most affected by the pandemic in Vanier, Ottawa. The VSPH is a multidisciplinary organization that uses a community-based social pediatrics model to optimize the health and wellbeing of underserved children and youth with psychosocial needs through integrated, individualized care and services.
There were varying reasons that students chose to join the NORTH Clinic:
“I knew I was always interested in SDOH. I had worked in the area but I hadn’t lived it and I haven’t had the privilege of working with people to hear their diverse stories and experiences around SDOH. I wanted to get practical experience to know how I could intervene rather than simply just know what SDOH are. That is why I wanted to join the clinic. I feel that I have a better understanding now of SDOH.”
– Jessie, medical student
“My parents were immigrants and we didn’t have a great deal of income growing up. I wanted to join NORTH to give back.”
– Trisha, law student
During the course of the clinic, meaningful encounters with clients helped solidify or reinforce the importance and cement the value of SDOH:
“I see social and medical concerns to be completely intertwined. In medical school, we are mostly taught about the biological factors that make people healthy or not. However, through the NORTH clinic, it is so clear that biological factors only scratch the surface. I really want my future clinical practice to focus on SDOH”
– Emily, medical student
Moreover, there were many skills that were developed through the Clinic:
“The interdisciplinary nature of this clinic was fantastic. I would learn so much from the law students. One time, we were talking about refugee and newcomer law or the IFH program, another time we were discussing housing law. I was like, oh my goodness, lightbulb moment, I want to work with lawyers at my future clinic. They know so much. Our patients need us to work together.”
– Jess, law student
“The social workers were wonderful. I loved working with them. I really wanted to learn more about things like trauma informed care in medical school and was disappointed that I didn’t have the opportunity to do so which is why I wanted to join NORTH. I think the feedback and training from the social workers is invaluable.”
– Misha, medical student
“I learned a lot about listening and compassion and empathy. I think I learned that it is really valuable to just sit on your hands and hear what people have to say. That is the most important thing I learned.”